Provider Demographics
NPI:1558408724
Name:WHITE, SCOTT CHRISTOPHER I (BS, QMHA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:CHRISTOPHER
Last Name:WHITE
Suffix:I
Gender:M
Credentials:BS, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4997 SE 30TH AVE
Mailing Address - Street 2:APT. 15
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-4435
Mailing Address - Country:US
Mailing Address - Phone:503-274-6528
Mailing Address - Fax:
Practice Address - Street 1:412 SW 12TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2329
Practice Address - Country:US
Practice Address - Phone:503-228-7134
Practice Address - Fax:503-273-8431
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator